BACKGROUND: The primary outcome of sugammadex reversal for rocuronium-induced neuromuscular block (NMB) is a train-of-four ratio (TOFR) of 0.9, not first twitch (T1) height. We investigated whether the recovery of TOFR or T1 differs based on the reversal of NMB with neostigmine or sugammadex. METHODS: The acceleromyographic responses from 0.6 mg/kg of rocuronium were monitored supramaximally in 80 patients after induction of anesthesia. The TOFR and T1 height were recorded, and saved in a personal computer using TOF-Watch SX Monitor software in all patients. Patients were randomly assigned to 2 groups to receive either neostigmine 50 µg/kg with glycopyrrolate 10 µg/kg (neostigmine group, n = 40) or sugammadex 2.0 mg/kg (sugammadex group, n = 40). The primary objective was to determine the difference of recovery time between TOFR to 0.9 and T1 to 0.9 after sugammadex or neostigmine administration during moderate rocuronium-induced NMB. RESULTS: The recovery pattern of the TOFR 2 min after sugammadex administration was 1.0 or more, but that of T1 was less than 90% (T1 / control value) up to 6 min after drug was injected. The recovery pattern of TOFR and T1 was similar during the 20 min after reversal with neostigmine. CONCLUSIONS: If you have not performed the T1 monitoring, both TOFR and T1 should be considered to confirm suitable recovery during the 6 min after reversal with sugammadex during rocuronium-induced moderate NMB.
Anesthesia ; Depression* ; Glycopyrrolate ; Humans ; Microcomputers ; Neostigmine ; Neuromuscular Blockade* ; Neuromuscular Monitoring

BACKGROUND: Postoperative nausea and vomiting (PONV) has a remarkably high reported incidence (70%) in female patients after anesthesia. This study aims to evaluate the clinical effect of capsicum plaster at the P6 acupoint with respect to gender in preventing PONV after laparoscopic cholecystectomy. METHODS: A prospective, placebo-controlled, double-blind study was conducted with 120 patients undergoing laparoscopic cholecystectomy and who were randomly assigned to four groups (n = 30 each): Group MC = male patients with capsicum plaster at the P6 acupoint; Group MP = male patients with placebo tape at the P6 acupoint; Group FC = female patients with capsicum plaster at the P6 acupoint; Group FP = female patients with placebo tape at the P6 acupoint. The treatment tape was applied before the induction of anesthesia and was removed eight hours after the operation. RESULTS: The incidence of nausea was reduced in both genders with application of capsicum plaster at P6 acupoint. No change in vomiting or use of anti-emetics was observed. Satisfaction scores with PONV control were improved with this intervention. No gender difference was observed which actually the initial objective of this study was. CONCLUSIONS: The application of capsicum plaster at the P6 acupoint is a proven antiemetic method in both gender after laparoscopic cholecystectomy, however there are no intergender differences.
Acupuncture ; Acupuncture Points* ; Anesthesia ; Antiemetics ; Capsaicin ; Capsicum* ; Cholecystectomy, Laparoscopic* ; Double-Blind Method ; Female ; Humans ; Incidence ; Male ; Nausea ; Postoperative Nausea and Vomiting* ; Prospective Studies ; Vomiting

OBJECTIVES: It has been known that children reved symptoms of Posttraumatic Stress Disorder (PTSD) after experiencing traumas similar to adults. But there are a few studies regarding the psychopathologies of PTSD in preschool children. Considering more active brain and psychological development in preschool children, it is expected that trauma of preschool children causes more serious psychopathologies than those of children with older ages or adults. This study aims to investigate psychopathologies of 9 preschool children experiencing a single, severe trauma, specifically in the respect of PTSD diagnosis. METHODS: Nine preschool children, 3-5 years old, experiencing physical injuries caused by attack from a psychotic patient during lunch time at kindergarten, were evaluated for clinical diagnoses through semi-structured interviews using Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) and Research Diagnostic Criteria (RDC for Kiddies) of PTSD for preschool children. RESULTS: Five (56% by DSM-IV) and Six (67%, by RDC) out of 9 children were diagnosed as to have PTSD. Among those children with PTSD, four (44%) showed Separation Anxiety Disorder (SAD) and one (17%) showed Major Depressive disorder (MDD) as comorbid diagnoses. On subclinical level, two of 9 children (22%) suffered from separation anxiety, seven (78%) from aggressive behaviors, and two (22%) from depressive mood. Sleep disturbances (89%) and reexperiencing of trauma (89%) were the most prominent symptoms of PTSD in preschool children. CONCLUSION: While preschool children showed profiles of PTSD symptoms similar to those of adults, it was critical to use more developmentally sensitive diagnostic tools for a better detection of psychopathologies. Young children experiencing severe trauma showed other comorbid psychopathologies along with PTSD. For proper diagnosis and intervention, it is important to make an accurate clinical diagnosis based on developmentally appropriate diagnostic process and tools.
Adult ; Anxiety, Separation ; Brain ; Child ; Child, Preschool* ; Depressive Disorder, Major ; Diagnosis ; Humans ; Lunch ; Mood Disorders ; Schizophrenia ; Stress Disorders, Post-Traumatic

Anaphylaxis during the perioperative period is rare, but it still causes severe cardiovascular and respiratory collapse that can be fatal. In particular, when using antibiotics that have a high risk of hypersensitivity reactions, it is important to establish that intradermal skin tests are negative before using antibiotics. We report a case of anaphylactic shock occurring during general anesthesia after using an intradermal skin test-negative antibiotic. Regrettably, negative results of intradermal skin tests before using antibiotics do not completely eliminate the risk of anaphylaxis. Therefore, anesthesiologists should be prepared for anaphylaxis to occur at any point during the perioperative period.
Anaphylaxis* ; Anesthesia, General* ; Anti-Bacterial Agents ; Hypersensitivity ; Intradermal Tests ; Perioperative Period ; Skin Tests ; Skin*

Vaccination is an important strategy for controlling the coronavirus disease 2019 (COVID-19) pandemic. We conducted a web-based cross-sectional survey based on Google Forms to collect data on adverse events (AEs) after the first dose of the ChAdOx1 nCoV-19 vaccine for healthcare workers (HCWs). Among the 1,676 vaccinated HCWs, 59.5% (998/1,676) responded to the survey. In total, 809 (81.1%) respondents reported experiencing AEs. There were no serious AEs, such as anaphylaxis. The most common AE was pain at the injection site (76.2%), followed by fatigue (75.9%), myalgia (74.9%), and fever (58.4%). HCWs in the younger age group experienced significantly more AEs than in the older age group.

Vaccination is an important strategy for controlling the coronavirus disease 2019 (COVID-19) pandemic. We conducted a web-based cross-sectional survey based on Google Forms to collect data on adverse events (AEs) after the first dose of the ChAdOx1 nCoV-19 vaccine for healthcare workers (HCWs). Among the 1,676 vaccinated HCWs, 59.5% (998/1,676) responded to the survey. In total, 809 (81.1%) respondents reported experiencing AEs. There were no serious AEs, such as anaphylaxis. The most common AE was pain at the injection site (76.2%), followed by fatigue (75.9%), myalgia (74.9%), and fever (58.4%). HCWs in the younger age group experienced significantly more AEs than in the older age group.

Laparoscopic cholecystectomy is the treatment of choice for cholelithiasis. It is used more commonly than open cholecystectomy because of the convenience of a short hospital stay and earlier return to work, and for aesthetic reasons. Nevertheless, there are complications that are encountered more frequently than in open cholecystectomy due to the smaller operating window. Here, we report the case of a 73-year-old woman who underwent a laparoscopic cholecystectomy 15 years earlier and now presented with abrupt abdominal pain. Abdominal computed tomography (CT) revealed a past cholecystectomy with an abscess pocket abutting the abdominal wall, with a stone inside it. Incision and drainage were done and the stone was removed laparoscopically. This case shows that late complications, such as abscess formation due to lost GB stones during laparoscopic cholecystectomy, can occur, even after 15 years.
Abdominal Abscess ; Abdominal Pain ; Abdominal Wall ; Abscess ; Aged ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholelithiasis ; Drainage ; Female ; Humans ; Length of Stay ; Return to Work

Dry mouth is a common symptom in over middle- aged women. Xerostomia itself can be caused by multifactorial etiolgy. Dry mouth may occur with the use of medications, as a complication of connective tissue and autoimmune disease, such as Sjogren's syndrome or sicca syndrome, with radiation therapy to the head and neck or diabetes mellitus, or with a number of other condition. Even stress and anxiety can lead to a dry mouth. Also, Abnormal liver function is associated with drugs, viral infection, alcohol, obesity, autoimmne disease and a number of other disease. A 41-year-old women complaining of xerostomia and known abnormal liver fuction since 1 year was admitted to our medical examination center. In this case, Final diagnosis was systemic lupus erythematosus with autoimmune hepatitis and secondary Sjogren's syndrome through characteristic clinical finding, liver biopsy, positive Schirmer's test, salivary gland biopsy, and salivary scintigraphy. The various immunosuppresant medication has taken and then liver function indices and clinical symptoms were improved.
Adult ; Anxiety ; Autoimmune Diseases ; Biopsy ; Connective Tissue ; Diabetes Mellitus ; Diagnosis ; Female ; Head ; Hepatitis, Autoimmune ; Humans ; Liver* ; Lupus Erythematosus, Systemic* ; Mouth ; Neck ; Obesity ; Radionuclide Imaging ; Salivary Glands ; Sjogren's Syndrome ; Xerostomia*

We performed a point seroprevalence survey of measles among healthcare workers (HCWs) at two Korean teaching hospitals in 2019. A total of 2,830 HCWs underwent an antibody test.The overall seropositivity of measles was 93.1%. The seroprevalence of measles was lowest in HCWs aged 20 - 24 years (81.2%), followed by those aged 25 - 29 years (90.1%). The rates of anti-measles IgG positivity were significantly different between the two hospitals (97.0% vs.89.4%, P <0.001). These results suggest that the seropositivity of measles in HCWs may differ depending on the hospital's vaccination policy.

Purpose: To assess the diagnostic potential of whole-exome sequencing (WES) and elucidate the clinical and genetic characteristics of primary ciliary dyskinesia (PCD) in the Korean population. Materials and Methods: Forty-seven patients clinically suspected of having PCD were enrolled at a tertiary medical center. WES was performed in all patients, and seven patients received biopsy of cilia and transmission electron microscopy (TEM). Results: Overall, PCD was diagnosed in 10 (21.3%) patients: eight by WES (8/47, 17%), four by TEM. Among patients diagnosed as PCD based on TEM results, two patients showed consistent results with WES and TEM of PCD (2/4, 50%). In addition, five patients, who were not included in the final PCD diagnosis group, had variants of unknown significance in PCD-related genes (5/47, 10.6%).The most frequent pathogenic (P)/likely pathogenic (LP) variants were detected in DNAH11 (n=4, 21.1%), DRC1 (n=4, 21.1%), and DNAH5 (n=4, 21.1%). Among the detected 17 P/LP variants in PCD-related genes in this study, 8 (47.1%) were identified as novel variants. Regarding the genotype–phenotype correlation in this study, the authors experienced severe PCD cases caused by the LP/P variants in MCIDAS, DRC1, and CCDC39. Conclusion Through this study, we were able to confirm the value of WES as one of the diagnostic tools for PCD, which increases with TEM, rather than single gene tests. These results will prove useful to hospitals with limited access to PCD diagnostic testing but with relatively efficient in-house or outsourced access to genetic testing at a pre-symptomatic or early disease stage.